Mammography - in the wake of breast cancer 2

Mammography – in the wake of breast cancer

Mammography is an X-ray procedure used to detect early breast cancer as well as to shed light on suspected findings in a woman's breast. In addition, all women between the ages of 50 and 69 in Germany are routinely invited for breast cancer screening (mammogram) every two years. Read about here when a mammogram makes sense, how it is performed and what risks it presents.

A woman on a mammogram
In young women, mammograms are performed only if there is suspected breast cancer, and since the age of 50, it has been associated with cancer prevention.
© iStock.com/gorodenkoff

Mammography (alternatively: mammography) refers to a breast x-ray (Latin: mom) for the early detection of breast cancer. Mammography reveals the slightest contrast between soft tissue and microcalcification. This makes them the most important imaging technique in the diagnosis of breast cancer.

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Mammography: (Ab) when does that make sense?

Each year, about 72,000 women in Germany have breast cancer. Because of this, breast cancer is the most commonly diagnosed cancer in women. Breast cancer risk is mostly age-dependent. Only 18 percent of breast cancers occur before age 50. Women between the ages of 50 and 69 are most likely to develop breast cancer. The main tasks of mammography are early detection of asymptomatic stages, as well as accurate diagnosis of suspicious findings. Therefore, mammography is useful especially in the following cases:

  • to clarify suspicious findingsif irregularities are found in gynecologists' breast or palpation tests

  • in high-risk patients, whose family had breast or ovarian cancer

  • in the context of organized screening (Projections) for all women ages 50-69

  • subsequent tumor treatment after breast cancer preservation therapy

The following symptoms are used as an indicator of pathological changes that make a mammogram necessary:

  • limited out-of-focus nodes

  • A knot in the armpit

  • Hardening, protrusions or thickening

  • Changes in breast size and outline

  • Changes in the skin due to redness or withdrawal of skin tissue

  • Retraction or lesions on the nipples

  • The discharge of fluid from the nipple

Both in the case of doubt and as part of the mammogram examination, the cost of the mammogram is covered by health insurance.

Mammogram expiration

Since the examination is performed on the upper body, women should resort to easily removable clothing. Furthermore, you should do without deodorant before testing as this leaves irritating residues on the x-ray.

The best time for a mammogram is during the period or the week that follows. At this point, the fluid content in the breast is lowest, x-rays are therefore the most significant and are best evaluated. Women who have already undergone menopause can be x-rayed at any time. In case of complaints or symptoms, the mammogram is also started at any time.

The mammogram lasts a maximum of half an hour. The pictures were taken while standing on your upper body. The breast is compressed between two radiolucent Plexiglas discs. This is sometimes perceived as uncomfortable and painful.

However, this procedure optimizes the result: Small breast thickness minimizes radiation dose and optimally reproduces sharpness and contrast. Two shots were taken from two sides. Once from top to bottom and once diagonally from center to side. An X-ray of both breasts is necessary so we can better recognize the differences in comparison. In two-dimensional black and white images, the doctor examines the skin and subcutaneous tissue as well as the skin and mammary gland tissue. If there is reasonable doubt, further investigations are initiated.

After the mammogram

In about five to ten percent of cases, women are referred again to a breast center or clinic for a suspicion found through a mammogram examination. In this case, further testing is required – such as a new mammogram, ultrasound or biopsy (tissue sampling).

In most cases, this is a "false alarm", which means that further action does not confirm suspicion. Only one to two in ten women with a suspected mammographic finding confirm a suspected breast cancer.

Mammogram: yes or no?

Mammography is an X-ray, thus creating radiation that pollutes the body. However, the risk of producing X-rays for cancer is much less than the risk of the tumor finding undetected. Modern technology and devices maintain low radiation exposure. Mammography requires an average radiation dose of 0.2 to 0.3 milliseconds. In comparison, it is often referred to as average natural radiation, which is exposed annually in Germany. This is 2.1 million.

As a drawback, mammograms are also false positives as well as false negatives. The sensitivity of the investigation is 70 to 75 percent. This means that despite mammograms, 25 to 30 percent of breast cancers remain undetected. If the next trial is done after two years, these false-negative findings can significantly complicate timely treatment intervention.

In the case of false positives, the psychological aspect is above all Foreground: Women who receive this diagnosis are unnecessarily disturbed and must undergo additional, unnecessary examinations.

Many early forms of breast cancer are found through mammography. However, the development of a malignant tumor cannot be evaluated using an X-ray. To minimize the risk, precautionary surgery is advised in most cases. The problem of not being able to distinguish between critical and harmless findings often leads to over-treatment of women.

Despite the problems listed here, the benefits of early detection are far more important. At the age of 40, the individual benefit of mammography outweighs the risk of exposure to steel. There is an optimal benefit-risk balance between the ages of 50 and 70.

An alternative to mammography

Mammography does not prevent breast cancer or reduce the risk of disease. However, it does allow the recognition of tumors at an early stage, increasing the chances of rapid healing. Early detection helps improve the chances of recovery with timely therapy and ultimately reduces the mortality rate.

The following alternative screening methods are available for women who refuse mammograms:

sampling: From the age of 30, women are eligible for breast cancer screening once a year for cancer screening. Women should also be trained in how they can feel their breasts themselves. Irregularities detected during palpation can be further explained in the context of mammography.

sonography: Ultrasound examination of the breast is performed mainly in young women, because the glandular tissue still has a high density, which complicates the evaluation of x-rays. Mammography before the age of 35 is therefore less useful. This also applies to women who use hormonal contraception, as well as those undergoing hormone replacement therapy for menopausal symptoms. Sonography is not a substitute for mammography. It is used more as a complementary method to clarify findings.

Magnetic resonance imaging of the breast: This method is also not one of the routine breast cancer diagnostics. It is targeted at women who have already been diagnosed with breast cancer to look for other nodes. Following breast conservation surgery, magnetic resonance imaging is used to better evaluate surgical scars after abnormalities. Only then is this diagnostic procedure also cash flow.

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